The United States’ Greatest Barriers to Improved Mental Health Care Services and What Advocates Can Do to Enhance Care

The United States’ Greatest Barriers to Improved Mental Health Care Services and What Advocates Can Do to Enhance Care

What stops people who need mental health treatment from getting the support they need? While on average one in five American adults experiences some form of mental illness every year, just over 40% of people living with a mental health disorder receive treatment. What happened to discourage the other 60% of people from getting help and what can we do about it?

One of the greatest barriers to seeking mental health care is system capacity. There just aren’t enough mental health professionals or treatment centers available to meet the needs of the millions of Americans who need mental health treatment, including treatment for addiction.

Quality insurance coverage for mental health issues can also be a barrier to mental health treatment. Access to affordable health insurance eased somewhat with many states’ Medicaid expansions to include people within 138% of the federal poverty threshold. However, as Congress stands poised to repeal the Affordable Care Act (ACA), and without a concrete plan describing what will follow the ACA, some people may stand to lose their health insurance coverage. Estimates are that this number of people currently insured who will lose their access to care could be in the tens of millions.

The proposed shift in federal Medicaid funding from an open-ended entitlement program to a fixed-rate block grant is likely to decrease states’ available mental health resources as well. Opponents of the shift are concerned that one of the implicit goals of changing to a block grant funding structure is to save the government money, but in state budgets this cut could mean administrators will have to choose between the medical needs of different disadvantaged populations. If Medicaid becomes a block grant funded program, anyone utilizing the social safety net to connect to life saving treatment, including addiction treatment and outpatient counseling services, will likely lose some if not all of their benefits.

Entrenched social stigmas and cultural values also pose a major barrier to mental health treatment. Strict religious attitudes that equate mental health issues with moral weakness contribute to an environment that blames people for their mental health conditions instead of offering compassion and treatment.

While these and many other barriers to mental health treatment, including geographic location, primary language and immigration status, can prevent someone from getting the treatment they need, there is plenty that healthcare advocates can do to impact this situation. Participate in one of your state, city or county’s mental health awareness campaigns to raise the visibility of these issues and highlight the need for treatment and acceptance, not stigma. Petition your elected representatives directly to tell them a block-grant funding structure will spell disaster for people you care for if you know people who are benefiting from or need access to Medicaid. Find an organization working on affordable mental health care in your community and offer to volunteer in whatever way you can be of service. By recognizing our shared struggles and values, mental health care advocates can make a difference in the way our country addresses this vital issue.

January 30, 2017  Comments Off on The United States’ Greatest Barriers to Improved Mental Health Care Services and What Advocates Can Do to Enhance Care

How Medicaid’s Addiction Treatment Services Will Change as a Block-Grant Program

How Medicaid’s Addiction Treatment Services Will Change as a Block-Grant Program

Last weekend Counselor to the President, Kellyanne Conway, said in an interview that replacing the Affordable Care Act could include a shift in Medicaid’s financing to block grants. Since it was created in 1965, Medicaid has been a open-ended federal entitlement program, meaning that the federal government gave more money to states if medicine became more expensive or more people needed coverage through the program; the program matched changing needs. Given the ongoing opioid epidemic and the importance of affordable health care, what would a change to Medicaid’s financing mean for people receiving services through state-based Medicaid expansion programs?

One part of the Affordable Care Act authorized the federal government to finance an expansion of state Medicaid programs, increasing federal funding in state health expenses to cover Americans within 138% of the federal poverty level. Under federal law, anyone who qualified for the state-based insurance coverage was entitled to a certain level of care for an array of physical and mental health services, including addiction treatment services.

Currently the number of people accessing mental health or addiction treatment services varies greatly from state to state. In Ohio more than 500,000 adults received treatment for mental health and/or addiction treatment services through the state’s Medicaid expansion program, while states like Texas did not expand Medicaid at all. But because even the states that didn’t expand Medicaid still benefit from federal funding for patients at or below the national poverty level, anyone enrolled in Medicaid is likely to be impacted by the proposed shift to block grant financing.

Unlike how Medicaid funding works now, block grants do not respond to economic changes. Block grant funding is a type of financial dispersal in which the federal government gives states as a sum with general provisions on how it is to be spent. The amount is set, but states use it as they please. This is done because states vary in the types of programs they have to meet local needs. For example, the federal government might give each state a million dollars for road improvement. One state might fix potholes. Another might repair a bridge. A third might build part of a new road. All these expenditures would be allowable with a block grant for roads. Unfortunately, these grants do not take into account need, so a state that has an increased need for road improvement because of storm damage would not receive more aid based on that need.

Exactly what the change looks like will vary depending on the kind of block grants the federal government administers to states. In a fixed rate model, the government agrees to pay states a fixed amount of money, no matter how many people need coverage or what kinds of health services they need.

Alternatively, the federal government could agree to pay states a certain amount of money for each person the state’s Medicaid program elects to cover. This per capita allotment model is intended to account for ebbs and flows in the economy, when more or fewer people utilize government safety nets to meet basic needs like health coverage. This will cost the federal government more in times when the economy is poorest. Also, unless they’re adjusted for inflation both fixed and per-capita block grants would mean a smaller and smaller pool of funds every year, suggesting a slow death of attrition for Medicaid as a federal program.

Twelve percent of Medicaid enrollees are diagnosed with a substance use disorder (SUD). If federal funding for health care shrinks overall and coverage for all conditions decreases, it makes sense that coverage for addiction treatment services will decrease as well. Limiting access to addiction treatment services could be a disaster, resulting in thousands of preventable deaths.

It is crucial that everyone be able to access quality addiction treatment, no matter their income. At the end of Conway’s interview, she confirmed that President Trump is committed to keeping health care affordable and accessible to all. In order to meet this goal, special attention needs to be paid to health care services to the poor and how those services will be funded.

January 25, 2017  Comments Off on How Medicaid’s Addiction Treatment Services Will Change as a Block-Grant Program

Opioid Addiction is Predictable and Potentially Avoidable if Physicians Change Screening Habits

Opioid Addiction is Predictable and Potentially Avoidable if Physicians Change Screening Habits

Most people only use prescription opioids for a short period of time. According to a new study published in PAIN, The Journal of the International Association for the Study of Pain, less than two percent of people prescribed opioid-based pain killers are still legally taking them six months after they’re first prescribed. Even while the prescription opioid epidemic continues to wreak havoc on public health across the country, for most people who find themselves filling a prescription for opioid-based medication, their experience with the notorious class of drugs will be short and uneventful.

There are some people, though, for whom the risks of a prescription for opioid-based pain killers could outweigh possible benefits. These are people who may become addicted in that short period of legal use. Researchers from the same study that found a mere 1.7% of people legally continue taking prescription opioids after six months also identified certain risk factors associated with prescription opioids that increase the likelihood a person will develop an addiction to the drugs.

Specifically, researchers found that patients with a history of anxiety, depression or self-injury were more likely to continue using prescription opioids for more than six months, correlating with a higher likelihood of abuse. Not surprisingly, researchers also found that a history of substance abuse made individuals statistically more likely to misuse or develop a dependence on prescription opioids. Being involved in a motor vehicle accident or having a diagnosed sleep disorder and/or a history of taking other psychotropic medicine also puts patients at a higher risk for opioid abuse.

The good news? These are all risk factors physicians can screen for before prescribing opioid painkillers.

That’s not all. Prolonged use of prescription opioids can also increase a patient’s likelihood of developing other harmful conditions in addition to addiction. A study conducted by researchers at the St. Louis University School of Medicine and published in the Annals of Family Medicine found that patients using prescription opioids for more than thirty days were at increased risk of developing depression.

As a debilitating yet common mental health condition, depression is itself a risk factor for developing an addiction. Prescribing opioid-based medications not only puts the patient at a higher risk for addiction; continued use of prescription opioids over time interacts with an individual’s brain chemistry to foster mental health conditions that predispose to addiction. It’s a catch-22. Opioids can be the switch that flips a person into a dangerous circle of mental illness and addiction.

Although the Centers for Disease Control recently released new clinical guidelines for prescribing opioids, especially for the treatment of chronic pain, there are no formal protocols in place that require a doctor to follow these guidelines when seeing patients.

Doctors now have solid, new information to help their patients avoid opioid abuse. These studies’ findings point to concrete risk factors associated with long-term opioid abuse; they should be embraced by physicians. Following thorough protocols to determine when it is safe and most appropriate to prescribe opioid-based medications, including instituting a screen for patients to identify risk factors, is essential to ending the opioid overdose epidemic.

January 17, 2017  Comments Off on Opioid Addiction is Predictable and Potentially Avoidable if Physicians Change Screening Habits

We Need Leadership: Here’s How President Trump and Incoming HHS Secretary Tom Price Can End the Nation’s Addiction Crisis

We Need Leadership: Here’s How President Trump and Incoming HHS Secretary Tom Price Can End the Nation’s Addiction Crisis

 

With the fate of the Affordable Care Act still up in the air, it’s not clear what health care will look like under President-elect Donald Trump. But as the opioid crisis rages on, Trump’s administration can’t afford to waste any time without a concrete plan to combat this epidemic. Last November, the Department of Health and Human Services (DHHS) released its first ever Surgeon General’s Report focused specifically on drug misuse and abuse in the United States. Here are the keys to an effective DHHS policy outlined in the Surgeon General’s Report that the agency must embrace in order to win the fight against addiction.

 

Consider Practical Neurobiology. More than ever before, scientific evidence is demonstrating the clear relationship between the brain’s neural reward pathways and addiction. Drugs like alcohol, cocaine and prescription opioids dump feel-good neurotransmitters into the brain, redirecting natural urges to eat or sleep into an all-consuming craving for the user’s drug of choice. Integrating this practical neurobiology and moving away from addiction treatment models that use shame to discourage people from using drugs is essential to decreasing overdose-related deaths.

 

Implement Preventative Education as Public Policy. The best protection against addiction is prevention. The good news is that we already have a slew of evidence-based public policies outlined by the Surgeon General that we know will decrease addiction rates. An effective DHHS will thoughtfully use the power of addiction prevention public policies and programs to reduce the stigma surrounding addiction to replace it with knowledge, understanding and compassion, so that those who need treatment can and will seek it.

 

Promote Inclusive Medical Coverage. Once someone addicted to drugs or alcohol is ready to receive treatment and enter recovery, quickly connecting them to treatment is crucial. Addiction is a deadly disorder that deserves the same level of quality, intensive care a cancer patient can expect from our health care system. This means the next DHHS Secretary must push to protect the Mental Health Parity and Addiction Equity Act, legislation that prevents insurers from providing decreased benefits based on the nature of an illness, and other measures that would secure substance abuse treatment for millions of Americans.

 

Continue to Be Accountable. As Surgeon General Murthy noted, the report he released in November focused exclusively on drug addiction in the United States and was the first of its kind. If we expect to see continued improvements in the fight against addiction, especially the opioid abuse epidemic, continued communication with the American public on this issue is required. Our leaders owe it to us to show us just how hard they’re working to save the lives of our friends and loved ones; preparing regular reports will keep our officials accountable to the public and the public health goals they prioritize.

 

Ending addiction in the United States will require certain common sense actions: emphasize science and prevention; ensure access to quality treatment; and set ambitious goals for the country that we hold our leaders accountable to realizing. President-elect Trump is perfectly positioned to continue this work toward ending the spiral of ever-increasing substance abuse-related deaths. With millions of Americans’ lives at stake we must demand that our leaders see us through.

January 9, 2017  Comments Off on We Need Leadership: Here’s How President Trump and Incoming HHS Secretary Tom Price Can End the Nation’s Addiction Crisis

Changing the Brain: The Case for Incorporating Mind-Body Therapies into Addiction Treatment Programs

Changing the Brain: The Case for Incorporating Mind-Body Therapies into Addiction Treatment Programs

Mind-body therapies like meditation, acupuncture, and yoga have been practiced for thousands of years and offer practical methods to decrease stress levels and improve mood. But there’s more to mind-body therapies than meets the eye. While traditional medicine is slow to acknowledge the power of “intangible” treatment methods, new research shows conclusively that mind-body therapies act directly on the brain to alter its established neural connections for the better. Your ongoing meditation or yoga practice is more than a few quiet moments to yourself; your behavior is literally rewiring your brain to improve your ability to think and stave off the onset of some disease.

This is a crucial insight for addiction treatment providers. Addiction ravages the brain by redirecting our powerful neural reward system to prioritize the user’s drug of choice over the survival needs those systems were created for, namely food and reproduction. Introducing mind-body therapies into addiction treatment means going after the neurological disorder at its core and acknowledging the complicated biological incentives for substance abuse.

What does this mean for treatment practice or for an addict in recovery? At their core, mind-body therapies improve overall mental and physical health while improving brain function. These are practices that we should all engage in regularly, as a normal part of our days just like eating well and exercising.

There are three whole health practices that should receive special attention. These are meditation, yoga, and acupuncture.

Meditation not only reduces stress, but it also makes positive impacts on the brain by growing new gray matter. However, in order to gain this advantage of a calmer, healthier brain, you will have to meditate regularly. This is a commitment, but the results are worth it. Meditation decreases symptoms of depression and anxiety and can make you more willing to participate in other healthy activities.

Yoga also has tremendous health benefits and can be modified to fit your abilities and fitness level. Harvard university researchers note that yoga improves everything from heart health to body image. Other research shows the benefits of yoga to range from improving health in diabetic individuals to changes of consciousness that lead to a better overall sense of well-being.

Acupuncture’s goal is to restore and improve the body’s energy balance. Because of this, acupuncture addresses a wide range of conditions across the bio-psycho-social sphere. Those who use acupuncture report improvement of emotional issues, such as anxiety and depression, as well as physical problems, especially as a non-pharmaceutical tool for pain management. The best thing about acupuncture, for those with already busy schedules, is that it is passive. You simply go to the acupuncturist and lie on the table while the needles are inserted.

Attending to all aspects of our health, mind and body, is a good way to start off the new year. These whole health practices – meditation, yoga, and acupuncture – are good for addicts in recovery and all the rest of us who simply want to live fuller, healthier lives. What practices might you try to get the best out of 2017?

January 3, 2017  Comments Off on Changing the Brain: The Case for Incorporating Mind-Body Therapies into Addiction Treatment Programs

Making New Year’s Resolutions that Work in 2017

The key to making and keeping New Year’s resolutions is that they have to involve complete lifestyle change. Throwing money at a gym membership without a solid plan to change your lifestyle results in squandered money and disappointment. Here are six tips to help you create New Year’s resolutions that will actually change your life.

 

  1. Make a plan. If the change you want to make is important to you, you must make a plan to ensure that the change happens. For example, if you want to improve your fitness, you must identify a type of workout that you enjoy and schedule that workout into your day as a non-negotiable activity – the same way you schedule brushing your teeth. If you choose something you do not like or allow yourself to put the activity off, you’ve failed before you’ve begun.

 

  1. Make your change fun. If we address change with a bad attitude, it isn’t going to happen. If you dread an activity, you’re likely to let yourself off the hook by not continuing to do it. Are you trying to eat more fresh vegetables? Serve yourself on beautiful new plates or get flowers for your dining room table. Reward yourself for a week of healthful eating with ten dollars in a jar that you save up for a day at the spa. If you get short, medium, and long term rewards for your change, odds are better that you’ll stick with your program.

 

  1. Don’t glorify the past. If you tell yourself, “Boy, I sure do miss my morning donut,” then you can bet that pretty soon, you’re going to start pulling up to the donut shop. Once you’re past the initial shock of the change, think through relapse into old habits. Was the daily donut really better than the increased energy you have now? Most of us lie to ourselves to reinforce our old habits. Tell yourself the truth. Having another Christmas with the grandkids is a better outcome than stuffing your face with sugary treats after your doctor has warned you of the probable health outcomes.

 

  1. Set short term goals. If you need to lose a hundred pounds, that’s going to take time. It’s easy to get lost on the way to long term goals. Instead, set short term goals. After you lose the first ten pounds, reward yourself with new gym shoes. For fifteen pounds lost, take yourself to a movie with your best friend. If you set, attain, and reward yourself for short term goals, you’re more likely to make it to the end result you want to see.

 

  1. Be positive in your self-talk. If the whole time you’re on your evening walk you’re telling yourself that you’re a fat S.O.B. who can’t do anything right, you’re probably not going to continue with that activity for very long. Instead, tell yourself over and over how proud you are of yourself for making change. Look at you, up off the couch! You’re doing a great job! Congratulations for making an effort! Write yourself encouraging notes or postcards so you get something other than bills in the mail. You’re making changes to improve your life. You can do it!

 

  1. Ask for help. If change was easy, we would have no need for resolutions. If you need help, seek it out. Maybe you need a psychotherapist to help you sort out interpersonal issues or a life-coach or mentor to help you get your career on track. You might need a personal trainer to encourage you during your workouts or a friend to help you go through the pantry and get rid of all those things you shouldn’t eat. Use your support system to help you stay accountable to yourself.

 

Change isn’t easy, but with solid goals, a good attitude, positive self-talk, and maybe a little help, 2017 can be a new year in which you meet and exceed the goals you set for yourself.

December 29, 2016  Comments Off on Making New Year’s Resolutions that Work in 2017

Celebrate Your Nice List: Here’s Your Holiday Shopping Guide for Loved Ones in Recovery from Addiction

Celebrate Your Nice List:
Here’s Your Holiday Shopping Guide for Loved Ones in Recovery from Addiction

Holiday shopping season is in full swing. If you’re looking for the perfect gift for a loved one new to recovery, here are a few classic gift ideas you can be sure will make them smile and support their healthy lifestyle.

A blank journal. Writing in a journal at night before bed is a great way to process the events of the day as well as a nurturing, sustainable mental health tool. Your loved one can use the blank journal you give them to process their feelings, track projects and accomplishments, write poetry, compose songs, or begin an autobiography. Not much of a writer? Your loved one can still use the space to doodle, sketch or collect inspiring images and thoughts. The beauty of a blank journal is that the ways it can be used are limited only by imagination.

A high-end gym membership. It’s been proven time and again that regular exercise is not only good for your body, but an excellent therapy for the mind. The holidays are the perfect time to splurge on a loved one’s annual gym membership or spring for a series of specialized exercise classes, like water ballet or hot yoga. Being able to hit the gym when they’re frustrated or upset will give your loved one another positive health option to use instead of picking up their drug of choice.

Potted plants. The positive impact of nature on our psyche is so powerful that even just looking at images of natural scenes has been shown to boost mood by significant levels. Potted plants are very in vogue these days and come in all sorts of varieties that even the most brown-thumbed beginning gardeners can keep alive. Caring for another living thing can also help your loved one appreciate their compassionate side, even when they’re feeling down.

Show tickets. Tickets to a concert or show your loved one has had their eye on is another great gift idea perfect for someone in recovery. Having a date to look forward to in the future can help your loved one stay committed to their recovery even when the current day is a tough one.

Quality time. Don’t forget that the most valuable thing you have to offer a loved one can’t be wrapped or boxed up. Sharing time with your loved one, like sharing a hobby, catching a movie or just running errands together, is the most important gift you can give this holiday season. You can’t put a price tag on how good it feels to spend time with someone who understands you and will stick by your side.

Don’t stress if you didn’t find anything for your loved one in recovery from addiction on cyber Monday or black Friday. Simple but substantial gifts including quality time, a new potted plant or tickets to a favorite band’s next concert will get your message of love and appreciation across loud and clear. Your friendship means everything.

December 13, 2016  Comments Off on Celebrate Your Nice List: Here’s Your Holiday Shopping Guide for Loved Ones in Recovery from Addiction

Apples and Honey, but No Wine: Here’s How the High Holidays Can Support Your Recovery

Apples and Honey, but No Wine: Here’s How the High Holidays Can Support Your Recovery

A plane ticket home can burn a hole in your heart. Just thinking about how you’ll handle your family’s controversial politics or misaligned values can make even the calmest among us look around desperately for some way to make it through dinner. If you’re someone who has traditionally leaned on alcohol to get through the High Holy Days, you’re not alone; the alcohol industry makes a quarter of all its sales during the last quarter of the year, the holiday season.

If this is your first High Holy Day season in recovery, you know you’ll need a new plan to deal with the craziness or just plain rudeness that family seems so good at pulling out. Before you decide to cancel your trip home altogether, consider the ways you can use this family gathering to support your recovery instead of poking holes through it.

For example, chances are good that while you were using your drug of choice, you ended up making a few choices that you now regret. Although they are usually the last people we want to hurt, over the years our family and loved ones often bear the brunt of these mistakes. Once a situation has passed and months if not years have gone by, it can feel awkward to bring up an experience no one is proud of.

Rosh Hashanah, the Jewish holiday celebrating a new Hebrew calendar year and the holiday immediately preceding Yom Kippur, is all about reflecting on the past and making amends with those you have wronged. Citing this holiday and its imperative to seek out and make amends with those we have hurt is the perfect opportunity to bring up and apologize for the way you’ve acted in the past. Speaking to someone about a perceived wrong will also give them an opportunity to air out any feelings they’d like to share too, giving you both stronger footing in your relationship moving forward.

The holidays also give you an opportunity to create new, positive memories with your family to replace the ones you wish were different. Unfortunately, there’s no way to go back in time and undo what was done, whether you showed up to services or a meal drunk or never showed up at all. But don’t let your disappointment over what you did or didn’t do get in the way of enjoying your family now. 5777 is a new year and a new experience.

Always wished you’d made it to that dinner in 5774? Come early this year and help your mom prep the side dishes. Secretly missing how “fun” alcohol made an otherwise tense dinner? Try introducing the whole family to an innocuous but fun game that you can play around the table – taking everyone’s minds off the squabbles of the past.

Most importantly, remember to take care of yourself first. If you think seeing your family all together will prompt you to use, give yourself a pass from the occasion guilt-free. Find other ways to spend time with the family members you want to see. The people who love you will completely understand what a priority it is to you to maintain your recovery, and they’ll do everything in their power to keep you there. Protecting your life from relapse is one act you’ll never need to repent for.

October 3, 2016  Comments Off on Apples and Honey, but No Wine: Here’s How the High Holidays Can Support Your Recovery

Challenge is Inevitable, Stress is Not: The Case for Including Mental Health Care in the Workplace

Challenge is Inevitable, Stress is Not: The Case for Including Mental Health Care in the Workplace

Workplace stress comes from a wide variety of circumstances and situations. It’s easy to see how an attorney speaking on the record or a surgeon making that first incision could feel a twinge of anxiety or a rush of anticipation. But just because we don’t all have someone’s life or freedom in our hands doesn’t make our work any less anxiety producing. Stress that comes from or interferes with your work can have a huge negative impact on your quality of life, not to mention the quality of your performance. Employees and business owners alike have much to gain from a renewed commitment to work environments that promote positive mental health.

To supervisors and employers:

The first step towards implementing positive mental health policies and a caring culture at work is to develop a nuanced understanding of the kinds of pressures your employees are facing. There are some common stress and anxiety triggers that are nearly universal to the workplace, like facing strict deadlines and meeting customer demands. Specific fields will also have their own concerns that can ratchet up the anxiety level or dial it down, depending on the stakes at hand. Deepening your understanding of the challenges your employees can expect to face in their work will make you better equipped to handle common stressors and recognize disproportionate reactions to stressful situations.

Second, it is important to have a written plan for assisting employees who have mental health concerns. This includes everything from creating opportunities for stress relief to professional mental health support. There are some companies that have nap rooms, meditation times, yoga classes directly after work, or ping-pong tables in the break room – all as efforts to help employees relieve stress and be more productive. It is also important for employees to know where and how to seek help for life-concerns that can have a negative impact on work performance, such as the anxiety and stress caused by caring for aging parents, children who are ill or acting out, depression experienced by the employee or a family member, or substance abuse. The more support an employee has access to and they more encouraged they are to use that assistance, the better they will perform.

If you suspect that one of your employees is experiencing stress above and beyond the typical reaction in a given situation, pay attention. Better yet, anticipate the unforeseen by training employees or human resources staff to recognize the early warning signs of deteriorating mental health and guide the staff person to appropriate, supportive programs. Although this kind of investment in your business’ infrastructure will not bring you a direct profit, you can be sure that happier workers make for a more productive and dependable labor force.

You shouldn’t take for granted that your workplace positively contributes to your employees’ mental health. A healthy work environment should be challenging and stimulating for your employees, but if you push them too hard or stretch people too thin you’ll find yourself with more turnover and less productivity than is optimal. With the right prevention and support systems in place, you can play a role in helping your employees live happier, more productive lives.

September 28, 2016  Comments Off on Challenge is Inevitable, Stress is Not: The Case for Including Mental Health Care in the Workplace

Not Everyone Wants to Ban Kratom: Here Are Some Issues to Consider

Not Everyone Wants to Ban Kratom: Here Are Some Issues to Consider

Never heard of kratom? The media has been so focused on the ongoing opioid epidemic that it’s easy to miss a less frequently used or abused substance, like kratom. But a movement to ban or restrict the sale of kratom in cafes, at head shops and on the internet is gaining momentum across the country and states are taking legal action to curtail the public’s use of this drug. So what exactly is kratom, and why are people divided about its use?

Common in the United States for almost ten years before catching the attention of the federal government, kratom is a plant grown in Southeast Asia and cultivated as a kind of organic medicine. Currently the drug is classified by the Food and Drug Administration (FDA) as an herbal supplement. Kratom is primarily used to treat and manage pain, but it can also produce a euphoric high similar to, but not as strong as, that created by opiates like heroin. Kratom is also unique in that it creates both stimulant and depressive physiological responses in the brain, a potentially harmful combination.

Proponents of the drug point to its long-term, widespread use without serious public health repercussions as proof that overall, people are using the drug responsibly. A press release recently issued by the American Kratom Association (AKA) and the Botanical Education Alliance (BEA) condemns the Drug Enforcement Agency’s emergency action to make kratom a Schedule 1 substance, the same classification used for heroin and ecstasy. Banning kratom is really about creating the appearance of making progress in the fight against prescription opioids, the press release suggests, and is not in the best interest of the public.

Despite the benefits outlined by the AKA, BEA and other supporters, several states have already moved to ban or restrict the sale and possession of kratom. Some regulations focus on a mandatory minimum age for purchase, as is common with alcohol and tobacco, while other legislation blocks the use of kratom in the state by identifying it as a synthetic drug with the possibility of abuse. Several of the states that have already banned kratom cited a potential for abuse and addiction as a significant reason for their bans.

Kratom advocates are also concerned that many people who use the drug as a “less dangerous” alternative to heroin or prescription opioid painkillers or as an ongoing recovery support mechanism, in place of drugs like methadone or Suboxone, will relapse as a result of the national crackdown. These relapses could have deadly outcomes.

Addiction treatment professionals see the possibility for harm and some overdoses, but point out that there are several medications available to help opioid addicts, substances that have been researched and are regulated. Instead of relying on a drug that can itself be abused and cultivate addiction, addiction treatment professionals recommend utilizing medicines that have a proven safe dosage and that are regulated so that the user knows exactly what s/he is getting. Instead of kratom, medications like Vivitrol should at least be considered as an option. Addiction treatment professionals and organizations are wary of kratom as both a substance with addictive potential and an unstable coping mechanism to support recovery.

What is unacceptable is an outright ban on kratom without allowing scientists to study it. The plant has been used for hundreds of years and has regularly been used to treat both pain and to wean individuals off of opioids. It seems prudent to allow researchers to study the plant to find out which chemicals inherent in the substance provide medicinal effects and in what doses. We also need to know what long-term side-effects, if any, kratom causes, so that we can compare it with other medications for safety and efficacy.

It is in the public health interest to ensure that all substances that we ingest – be they foods, medicines, or supplements – are safe. Consumers need to know what’s in the products they buy and the dosage that will give them the best effect. While proponents of kratom downplay its potential for abuse and highlight its use for many as an addiction recovery or pain management tool, enabling continued use of kratom by the general public largely without restrictions of any kind contributes to a culture of addiction and obscures the prerogative of states and the country to protect citizens from potentially unsafe products. This drug should not be sold without regard to age in supplement stores or head shops. It is not a product that should be haphazardly used by teens or young adults. However, it also should not out of hand be made a Schedule 1 substance and research prohibited. Kratom should be studied so that those adults who might want to use it for pain relief or to assist with addiction treatment have a choice, assuming that it is found to be as safe and useful as proponents claim.

September 21, 2016  Comments Off on Not Everyone Wants to Ban Kratom: Here Are Some Issues to Consider

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